Abstract
Radical resection is only method of treatment giving the chance for long-term survival in the patients with pancreatic cancer with 5-year survival 11-28 %. Czech Republic is in the incidence of pancreatic cancer in the 6.place in Europe. 70-80 % patients are irresectable in the moment of diagnosis.
Patients with staging of T1-3, N0-1, M0 are indicated for radical resection with standard lymphadenectomy, resection of portomesenteric segment is indicated as a part of R0 resection. In the case of advanced carcinoma over that staging in patients in good condition palliative resection or biliodigestive anastomosis is indicated, in other cases endoscopic stenting.
Extended resections did not prove the benefit for patients. Current perioperative mortality is not over 3-5 %, morbidity reach till 60 %.
Pancreatic leak is the most serious complication. Adjuvant therapy significant prolongs survival after R0 resection.
Palliative chemotherapy prolongs survival in advanced carcinoma to compare to symptomatic therapy. The possibilities of neoadjuvant therapy are very limited.
Patients with pancreatic cancer should be concentrated to specialized center; therapy modality should be decided by multidisciplinary team.